Organization
SEQUOYAH COUNTY CITY OF SALLISAW HOSPITAL AUTHORITY
Active
Parent organization
SEQUOYAH COUNTY CITY OF SALLISAW HOSPITAL AUTHORITY
Other names
SMH Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
SEQUOYAH COUNTY CITY OF SALLISAW HOSPITAL AUTHORITY
Authorized official
MR. CHARLES E. WADE (CEO)
(918) 774-1100
Entity
Organization
Contact information
Practice address
1109 E CHEROKEE AVE, SALLISAW, OK 74955-5035
(918) 774-1100
(918) 774-1103
Mailing address
PO BOX 505, SALLISAW, OK 74955-0505
(918) 774-1100
(918) 774-1103
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
2189
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200091560M
—
OK
Enumeration date
03/20/2007
Last updated
06/18/2008
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